多参数流式细胞术对急性白血病治疗效果监测的前瞻性研究

 【摘要】　目的　探讨多参数流式细胞术（MPFC）在急性白血病患者治疗效果监测中的价值。方法　经诱导治疗达完全缓解的急性白血病住院患者，均于化疗前同时行骨髓细胞形态学检查和MPFC检查。对结果进行统计学分析，对MPFC检测阳性患者进行动态监测，观察其在随访期内是否形态学亦提示复发,及两者时间间隔。结果　共30例患者入组，提供122份标本，61份行骨髓细胞形态学检查，61份行MPFC检查。骨髓细胞形态学检查提示阳性的标本8份，阳性率13.11 %，MPFC检查提示阳性的标本18份，阳性率29.51 %。经配对χ2检验,两者差异有统计学意义（χ2＝4.33，P＜0.05）。MPFC检查提示阳性的18份标本来自10例患者，在随访期内（中位随访期6个月），6例患者分别于1～4个月内骨髓细胞形态学检查亦提示复发。1例患者失访，2例病程小于6个月的患者复查后转为阴性，1例患者死亡。结论　MPFC检查较骨髓细胞形态学检查更具敏感性，能够更客观地评估急性白血病的治疗效果，尽早发现复发。

Prospective study of multiparmeter flow cytometry for monitoring the treatment effect of acute leukemia

Objective To monitor the treatment effect of acute leukemia by multiparmeter flow cytomtry （MPFC）. Methods The patients with acute leukemia all achieved complete remission after remission induction therapy. Before the chemotherapy, the bone marrow cell morphology and MPFC inspection were used for each patient. Through statistical analysis, the relationship between morphological feature and recurrence, as well as time duration till recurrence were obersved. Results The 122 specimens from 30 patients were observed. The specimens were analyzed by morphological examination of bone marrow cells, and the other 61 specimen through MPFC. There were 8 positive specimen （13.11%） through morphological examination ,while 18 positive specimen （29.51% ） through MPFC. There was a significant difference between the two groupes by X~ test （Xa=4.33, P〈0.05）. The 18 MPFC-positive specimens were from 10 patients. In the follow-up period, there were 6 patients whose morphological examination also prompted the recurrence in 1-4 months. Three patients were failed to follow up because of 2 patients became negative and 1 patient died. Conclusion MPFC is more sensitive and able to assess the effect of acute leukemia treatment more objectively and detect the recurrence earlier than morphological examination.